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Jan 19

Experts discuss the association between low testosterone and kidney stones – Urology Times

In this video, Austin Thompson and Nannan Thirumavalavan, MD, discuss the background and key findings from the study, Low Serum Testosterone is Associated with an Increased Risk of First-time Nephrolithiasis in Men Without Testosterone Replacement Therapy. Thompson is a third-year medical student at Case Western Reserve University in Cleveland, Ohio, and Thirumavalavan is a urologist at University Hospitals in Cleveland, Ohio.

Video Transcript:

Could you describe the background for this work?

Thompson: The background from this work came from looking through the literature. We've known for a long time that as men aged testosterone decreases. But there's some recent articles showing that in younger men as well, we're starting to see low levels of testosterone. We use the AUA definition of below 300 ng/dL. From there, reading about kidney stones, as well, and the prevalence of kidney stones increasing over the years, we started to look to see what link may exist between those 2. What we found in the literature was that there's a lot of discrepancy with studies saying that low testosterone may be associated with kidney stones. There are studies that have not found an association. And then there are studies that have also shown that higher levels of testosterone may also be associated with kidney stones. So, with all that in mind, we felt that the TriNetX database, which is multi-institutional, even includes data from multiple countries, may be a good way to address this discrepancy that you see in the literature, because the ability to really apply good matching categories based on comorbidities, medications, with some of the other larger databases, to my knowledge, you're not able to do and things of that nature.

Thirumavalavan: Certainly, the biggest question that comes out of this is, is it the fact that many of the conditions that cause kidney stones also cause low testosterone, or are associated with it? For example, obesity, high blood pressure, or diabetes, metabolic syndrome, all of that is associated with low testosterone levels and is associated with kidney stones. The sicker you are, the more likely you are to have both of those things. So, the goal with this study is to control for as many of those factors as we can using TriNetX data and see if testosterone is still independently predictive of a first time kidney stone episode.

What were the notable findings from this study?

Thompson: The main finding is that when you look at men with low testosterone, grouped 18 and above, we found that there is an association between low testosterone and kidney stone encounter diagnoses. Then we subgrouped it as well by age cohorts. We also saw that in when 25 and above this association persists. When you look at some of the other studies that have investigated this is that men below the age of 40, no association has been seen with low testosterone and kidney stones. I think that the reason why we may have seen an association in younger men was because the scope of the TriNetX database were able to capture more patients in this younger age group, which may have allowed us to better investigate this association in men under 40.

This transcription has been edited for clarity.

Note: This project was supported in part bythe Clinical and Translational Science Collaborative of Northern Ohio, which is funded by the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Science Award grant, UM1TR004528.The content issolely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Jan 19

How to naturally boost testosterone levels for enhanced overall wellness – Fox News

How to naturally boost testosterone levels for enhanced overall wellness  Fox News

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Jan 19

Fracture Risk Bumped With Testosterone Therapy in Hypogonadal Men – Medpage Today

Testosterone treatment didn't offer protection against fractures in men with hypogonadism, a TRAVERSE subtrial indicated.

Compared with placebo, men who were on a testosterone gel actually had a significantly higher risk for fracture (HR 1.43, 95% CI 1.04-1.97), found Peter Snyder, MD, of the University of Pennsylvania in Philadelphia, and colleagues.

During the median 3.19-year follow-up, 91 men on testosterone experienced a clinical fracture compared with 64 men on placebo, excluding fractures of the sternum, fingers, toes, facial bones, and skull (3.50% vs 2.46%), the group wrote in the New England Journal of Medicine.

The researchers were quite surprised to find this, Snyder told MedPage Today, referencing how prior studies have demonstrated that testosterone increases bone structure and therefore might reduce the risk of fracture, in theory.

Testosterone-treated men had a numerically higher rate of all types of fractures compared with placebo, including:

In both groups, most of the fractures endured were associated with trauma, mostly commonly with falls. The most common fracture sites were ribs, wrist, and ankle. "These sites are of clinical significance because fractures at these sites are associated with low bone mineral density and with previous fractures and are therefore considered osteoporotic fractures," the researchers pointed out, adding that these fractures are also tied with increased risk for future fractures and death.

It's "unlikely" that this increased risk for osteoporosis fracture was a direct result of testosterone affecting bone structure and strength, argued accompanying editorial authors Mathis Grossmann, MD, PhD, of the University of Melbourne in Australia, and Bradley Anawalt, MD, of the University of Washington School of Medicine in Seattle. Instead, they think this more likely stemmed from a behavioral change from the testosterone bumping up engagement in physical activities.

Topline TRAVERSE findings, presented at the ENDO 2023 conference, found testosterone was noninferior to placebo for the occurrence of major adverse cardiac events in men with established or at high risk for cardiovascular disease. However, testosterone was linked with a higher rate of a few other risks compared with placebo including atrial fibrillation (3.5% vs 2.4%), acute kidney injury (2.3% vs 1.5%), and pulmonary embolism (0.9% vs 0.5%).

"Finding that testosterone treatment of men with late-onset hypogonadism increases fracture risk, together with the previously reported increased risk of atrial fibrillation and blood clots, outweighs the benefits of this treatment on improving sexual function and, to a lesser degree, walking and mood," said Snyder.

All in all, testosterone treatment of late-onset hypogonadism is simply not worth the risks, he warned other clinicians.

Another recent analysis from the trial found testosterone-treated men didn't have an increased risk for adverse prostate events. However, testosterone replacement therapy was linked with a significant increase in prostate-specific antigen (PSA) values compared with placebo as early as 3 months and persisted to 12 months.

Men ages 45 to 80 (median age 63) were included in the TRAVERSE trial if they had preexisting or high risk of cardiovascular disease, at least one symptom of hypogonadism, and two morning testosterone concentrations of less than 300 ng/dL (10.4 nmol/L) in fasting plasma samples obtained at least 48 hours apart. Those with a serum testosterone concentration of less than 100 ng/dL (3.5 nmol/L) or with conditions that might be worsened by testosterone treatment, like prostate cancer, were excluded. Average baseline BMI was 35.

The full-analysis population included 5,204 participants: 2,601 on testosterone and 2,603 on placebo. Testosterone-treated patients used a transdermal 1.62% testosterone gel with a goal of maintaining a serum testosterone concentration of 350 to 750 ng/dL and a hematocrit under 54%.

The median serum testosterone concentration in the testosterone group increased from 227 ng/dL at baseline to 368 ng/dL by month 6 and remained higher than baseline through year 3.

Some limitations of the study included that physical activity and risk-taking weren't assessed, nor were bone density and structure. Editorialists Grossmann and Anawalt said future studies must include measurements of behavior and physical function affecting fracture risk.

Kristen Monaco is a senior staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, shes worked at the company since 2015.

Disclosures

The trial was supported by AbbVie, Acerus Pharmaceuticals, Endo Pharmaceuticals, and Upsher-Smith Laboratories.

Snyder reported a relationship with AbbVie. Co-authors reported several ties with industry.

Primary Source

New England Journal of Medicine

Source Reference: Snyder PJ, et al "Testosterone treatment and fractures in men with hypogonadism" N Engl J Med 2024; DOI: 10.1056/NEJMoa2308836.

Secondary Source

New England Journal of Medicine

Source Reference: Grossmann M, Anawalt BD "Breaking news -- testosterone treatment and fractures in older men" N Engl J Med 2024; DOI: 10.1056/NEJMe2313787.

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Fracture Risk Bumped With Testosterone Therapy in Hypogonadal Men - Medpage Today

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Jan 19

Lipocine licenses Tlando testosterone therapy to Verity Pharma (NASDAQ:LPCN) – Seeking Alpha

Govind Oza/iStock via Getty Images

Lipocine (NASDAQ:LPCN) has entered a license agreement for its Tlando oral testosterone replacement therapy (TRT) with Verity Pharma.

The agreement will see Verity market Tlando in the U.S. - where it was approved in 2022 - and in Canada when it gets regulatory clearance. Verity will also hold development and commercialization rights to LPCN 1111 (Tlando XR), a "next generation" oral product candidate for TRT. It will be responsible for regulatory and marketing obligations in the U.S. and Canada.

Lipocine will get a $11M license fee and up to $259M in development and commercialization milestones. It retains rights to the Tlando franchise outside the US and Canada.

Antares Pharma - now part of Halozyme Therapeutics (HALO) - held exclusive licensing rights to Tlando at the time of the therapy's final approval by the U.S. FDA in 2022.

Shares of Lipocine (LPCN) rose as much as 12% premarket on Thursday

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Lipocine licenses Tlando testosterone therapy to Verity Pharma (NASDAQ:LPCN) - Seeking Alpha

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Jan 19

Testosterone Replacement Therapy and Prostate Cancer Risk – Medscape

Testosterone Replacement Therapy and Prostate Cancer Risk  Medscape

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Testosterone Replacement Therapy and Prostate Cancer Risk - Medscape

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Jan 19

Prostate Risks Similar for Testosterone Therapy and Placebo – Medscape

Prostate Risks Similar for Testosterone Therapy and Placebo  Medscape

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Prostate Risks Similar for Testosterone Therapy and Placebo - Medscape

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Jan 19

TRT Helped Me Lose Fat and Gain Muscle at the Same Time – The Edge

Even though my Hone physician told me I qualified for testosterone replacement therapy, I was hesitant to start. My husband is in grad school, so the cost of treatment made me reluctant to dive in. I put TRT on the back burner, and decided to start my fitness journey without hormone therapy.

In March 2023, I went all in. I didnt just want to lose weight, I wanted to gain muscle, too. Instead of focusing solely on weight loss measures like doing cardio and eating at a caloric deficit, I upped my protein intake to 190 grams per day and did strength training with a trainer four days a week.

By June, I lost around 20 pounds. But I just couldnt shake my low energy and sleep problems, which were affecting my motivation. So, with a bit of encouragement from a friend who saw me struggling, I decided to retest my hormones with Hone and start TRT.

My Hone physician said I was doing all the right things, but my T levels only clocked in at 367 ng/dL, which isnt optimal for my age. To get my hormones into the normal range, and improve my energy, Id need TRT. I was prescribed subcutaneous injections twice a week, with anastrozole to keep my estrogen levels in check.

In just three weeks, I felt more motivated to stick to my workout and diet. And, I was less irritable. I stopped feeling FOMO when I decide to skip nights of drinking with my friends.

Three months into treatment, my testosterone levels shot up to 1,178 ng/dL. The muscles in my shoulders bulked up and rounded outa physique that can take even the most committed gym-goers years to achieve. My stubborn belly fat practically melted away, revealing a solid four-pack.

Now seven months into treatment, I am around 190 pounds and have 9.4 percent body fat. I have a renewed sense of purpose, and I hit the gym six days a week. Im so close to my goal of getting a six pack.

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TRT Helped Me Lose Fat and Gain Muscle at the Same Time - The Edge

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Jan 19

11 of the Best Testosterone Boosters for Men in 2024 – HeraldScotland

Best Testosterone Boosters in 2024

Want to know more about the best testosterone boosters, how they work, and the research behind them? Read on to find out how the best testosterone boosters work to raise your testosterone levels and find the right brand for your needs.

Pros

Cons

TestoPrime stands out as an all-natural testosterone booster designed to revitalise youthful energy and vitality in men. Its formulation is geared towards boosting both physical and mental energy. This supplement plays a crucial role in supporting protein synthesis, which aids in burning unwanted fat while building lean muscle.

Additionally, TestoPrime enhances motivation by boosting confidence and mood. Its optimised metabolism contributes to effective thermogenesis, aiding in more efficient fat burning.

The distinct advantage of TestoPrime is its daily usability thanks to its natural ingredients. In addition to being one of the best testosterone boosters, TestoPrime also offers a 100% lifetime money-back guarantee, emphasising its confidence in delivering positive results.

>>Check the best prices for TestoPrime

Pros

Cons

D-Bal MAX is an effective testosterone booster for those struggling to gain muscle mass, especially for individuals who are naturally skinny and find it challenging to put on weight. Plus, it may provide the necessary boost to overcome plateaus in bulking efforts.

This supplement is also beneficial for those with a muscular build who want to lose fat without sacrificing muscle size. Additionally, D-Bal MAX is among the best testosterone boosters for people returning to training after a break, helping them reclaim their previously toned physique.

Its designed to support intense workout regimens and is more focused on muscle building and strength enhancement rather than quick weight loss.

>>Check the best prices for D-Bal MAX

Pros

Cons

Testo-Max is a natural testosterone booster designed to enhance muscle building without the need for illegal steroids. Its potent formula, comprising D-Aspartic acid, zinc, magnesium, and vitamins B6, D, and K1, works synergistically to elevate testosterone levels. This elevation leads to significant gains in strength, muscle mass, energy, and overall performance.

Ideal for those seeking to maximise their workouts, Testo-Max ensures explosive strength and insane workout capacity. It may also aid in achieving maximum muscle gains and ultra-rapid recovery times, making it one of the best testosterone boosters for fitness enthusiasts and bodybuilders.

>>Check the best prices for Testo-Max

Pros

Cons

Prime Male is one of the best testosterone boosters tailored for men aged 30 and older, aiming to restore the vigour and vitality of their youth. It works by supporting and elevating testosterone levels, which in turn assists in burning fat, building muscle, and increasing libido.

The supplement is formulated with a blend of 12 essential nutrients, each chosen for its critical role in enhancing health and fitness. Prime Male focuses on holistic vitality, addressing muscle strength, body composition, overall energy levels, and sexual health.

It's particularly effective for those looking to counteract the natural decline in testosterone levels that occurs with age, thereby helping to avoid related health issues.

>>Check the best prices for Prime Male

Pros

Cons

Testogen stands out as the best testosterone booster for fast results. Packed with natural and thoroughly tested ingredients like D-aspartic acid, fenugreek, and zinc, Testogen may support healthy testosterone levels.

The daily routine of taking four capsules each morning might lead to noticeable improvements in energy, mood, focus, and vitality within just two weeks. Additionally, users may expect muscle and strength gains in just one month when incorporated into their regular training program.

>>Check the best prices for Testogen

Pros

Cons

Testosil stands out among the best testosterone boosters tailored for those looking to elevate their exercise performance. It is a favourite among fitness enthusiasts looking to build strength and physical stature.

Additionally, it plays a significant role in reducing muscle damage caused by rigorous workouts by aiding in faster recovery. Beyond physical benefits, Testosil may also improve cognitive functions such as memory and executive functioning.

>>Check the best prices for Testosil

Pros

Cons

XWERKS Rise stands out for its focus on optimising essential nutrient and mineral levels, promoting muscle growth and overall strength. Its formulation is based on natural, proven ingredients that work synergistically to rejuvenate your physical performance.

As one of the best supplements to increase testosterone, it is effective in enhancing ones ability to gain strength and muscle, significantly maximising the results of gym workouts. Users have also reported a notable increase in energy levels, reminiscent of their younger selves but potentially even better.

>>Check the best prices for XWERKS Rise

Pros

Cons

TestoFuel is specifically designed as one of the best testosterone boosters for those looking to enhance muscle gains. It is designed to increase testosterone levels, providing the body with essential nutrients needed for this purpose.

This approach not only aids in accelerated muscle growth but might also contribute to an increase in muscle size and strength.

Additionally, TestoFuel may aid in reducing body fat, offering a more comprehensive physical transformation. An important benefit of increased testosterone is the improvement in mood, which aids in staying motivated and focused on fitness goals.

>>Check the best prices for TestoFuel

Pros

Cons

Provacyl stands out in the market for its unique formulation aimed at boosting testosterone and HGH (Human Growth Hormone) levels, particularly addressing the needs of ageing males. This supplement is crafted with herbs, nutrients, and amino acids designed to stimulate the body's natural hormone production, which tends to decrease with age.

Users have reported experiencing increased energy levels and a greater sex drive, along with improvements in mood and mental focus. Provacyl is also noted for its ability to decrease body fat and increase lean muscle mass, potentially helping to reduce some physical signs of ageing.

>>Check the best prices for Provacyl

Pros

Cons

Testodren distinguishes itself in the testosterone booster market with its unique, single-ingredient formula. It contains 500 mg of Furosap, a 100% natural and U.S.-patented compound derived from the Fenugreek herb.

Users of Testodren may expect an increase in overall energy, improved focus and concentration, faster muscle building, enhanced strength and stamina, and easier weight loss.

While the single-ingredient approach is a highlight, it may limit the diversity of benefits compared to multi-ingredient best testosterone supplements like TestoPrime.

>>Check the best prices for Testodren

Pros

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11 of the Best Testosterone Boosters for Men in 2024 - HeraldScotland

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Jan 19

How HRT impacts your voice – Will transition affect my singing? – GenderGP

Undergoing HRT causes various desired outcomes, and one of the possible impacts is the changing of your vocal chords, and thus, your voice.

Hormone replacement therapy (HRT) is a vital part of the gender transition process for many transgender people. While HRT can bring about significant physical and emotional changes, one aspect that often concerns singers or aspiring musicians is its potential effect on the singing voice.

When transmasculine individuals undergo HRT with testosterone, they often experience a significant change in their voice. The hormone leads to vocal masculinisation, which involves the thickening and lengthening of the vocal cords. This results in a deeper, more traditionally masculine voice. The degree of vocal change varies from person to person.

Singers who transition through testosterone may experience challenges in adapting to their new vocal range. It may take time and effort to retrain their voice and develop new vocal techniques to accommodate the lower pitch. Some singers may lose some of their higher vocal range, but with practice and vocal training, they can still sing and perform effectively. It's important to work with a vocal coach or speech therapist who can help navigate these changes.

For people who are transfeminine and take oestrogen, this hormone primarily affects secondary sexual characteristics, such as breast development and fat distribution. Unlike testosterone, oestrogen does not have a significant effect on the voice, meaning that there are generally no significant changes to the vocal range.

To preserve your singing voice while on HRT, especially if you're taking testosterone, you can consider the following strategies:

Taking a low dose of testosterone can help preserve your singing voice compared to a full dose. A lower dose of testosterone results in less dramatic changes in vocal pitch and quality. However, it's important to note that individual factors such as genetics and the duration of hormone replacement therapy (HRT) still influence the effect of testosterone on the voice. While a lower dose might be less impactful, more is needed to guarantee a complete preservation of the original voice. Vocal training and therapy can still be valuable in adapting to any changes.

The amount of testosterone taken can impact the rate and extent of voice changes. If a lower dose is taken, the changes will be more gradual and subtle, allowing some people to maintain a voice closer to their pre-HRT voice. A full dose, on the other hand, can result in more pronounced changes, leading to a deeper, more traditionally masculine voice. However, the extent of the change can vary significantly from person to person, and even with a lower dose, some may still experience noticeable differences in their voice, though to a lesser degree.

It takes time and practice to adapt to a new vocal range. Transgender people undergoing hormone replacement therapy (HRT) should be patient with themselves and practice regularly to strengthen their voices and become more comfortable with their new range.

Regular vocal exercises and warm-ups are essential in maintaining vocal health and flexibility. These exercises can help individuals extend their vocal range and improve their vocal control.

Some people may consider voice surgery. These surgical procedures can achieve a more desired vocal pitch and quality. However, surgery is an irreversible step and should be carefully considered.

Here are some common voice surgeries:

Undergoing HRT can have an impact on a person's singing voice. However, transgender people can maintain their singing abilities and continue their passion for music with determination, vocal training, and support. It's important to understand that the effects of HRT on the voice can vary from person to person. Thus, finding what works best for you is a unique and personal journey that may require patience and perseverance. With the right guidance and effort, it is possible to harmonise your voice with your authentic self.

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Jan 19

Lipocine rises on licensing deal for testosterone therapy in US, Canada – XM

BUZZ-Lipocine rises on licensing deal for testosterone therapy in US, Canada

** Shares of drug developer Lipocine LPCN.O rise 6.5% to $4.1 premarket

** Co enters into license agreement with Verity Pharma to market its testosterone replacement therapy, Tlando, in the United States and Canada

** Under terms of the deal, co to receive a license fee of $11 million

** Co to also receive up to $259 mln in development and commercial sales milestones

** Under the agreement, Verity Pharma will be responsible for regulatory and marketing obligations in the U.S. and Canada, and all further development of the therapy

** LPCN will retain all rights to the Tlando franchise for territories outside the U.S. and Canada

** Tlando was approved by the U.S. FDA in 2022 as an oral testosterone replacement therapy in adult males for conditions associated with a deficiency or absence of endogenous testosterone

** Stock fell 58.1% in the last 12 months

Reporting by Sneha S K

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